title: Does the magnetic-guided intramedullary nailing technique shorten operation time and radiation exposure?
abstract: OBJECTIVE
  The aim of this study is to show whether a new magnetic-guided locking technique is superior to a standard freehand technique in terms of operation time and radiation exposure. This treatment will be used for distal locking of the tibia during intramedullary nailing.
  
  
  METHODS
  This randomized trial is done through 80 patients having tibial fractures with a mean age of 25 years (range 16-67 years). In the magnetic locking group, there were 20 fractures of the distal third, 16 of the shaft, and 4 of the proximal tibia; in the freehand group, these numbers were 15, 20, and 5, respectively. The parameters like operation time, distal locking time, radiation exposure duration, and dose were compared.
  
  
  RESULTS
  We placed 100 distal locking screws in the magnetic locking group and 95 in the freehand group. Fluoroscopy was necessary only in the freehand group. All screws were correctly positioned the first time in both groups. The magnetic locking group had a shorter mean surgical time (52 ± 6.2 vs 70 ± 10.9 min; P < 0.01), a shorter mean distal locking time (5 ± 1.1 vs 16 ± 2.0 min; P < 0.01), and a shorter mean placement time for each screw (2 ± 0.5 vs 7 ± 1.2 min; P < 0.01). The magnetic locking group had lower mean radiation exposures (8 ± 4.5 vs 40 ± 7.6 s; P < 0.01) and mean radiation exposure (5.4 ± 2.5 vs 25 ± 6.8 mGy range; P < 0.01).
  
  
  CONCLUSIONS
  For distal locking during tibial intramedullary nailing, the magnetic locking system is as accurate as the standard freehand technique, but it has lower operative times and radiation exposures compared to the standard freehand technique. Therefore, the magnetic locking system should be preferred to current standard freehand techniques.
authors.affiliation: Orthopedics and Traumatology Clinic, Adana Numune Training and Research Hospital, Adana, Turkey.
authors.forename: Muhsin
authors.initials: M
authors.lastname: Dursun
authors.forename: Tughan
authors.initials: T
authors.lastname: Kalkan
authors.forename: Mahmut Nedim
authors.initials: MN
authors.lastname: Aytekin
authors.forename: Ismail
authors.initials: I
authors.lastname: Celik
authors.forename: Mahmut
authors.initials: M
authors.lastname: Uğurlu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001863:Bone Screws; D005260:Female; D005471:Fluoroscopy; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D059346:Magnets; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011829:Radiation Dosage; D013978:Tibial Fractures / Q000601:surgery*; D055815:Young Adult